Videolaparoscopic approach of the splenic cyst: a case report.

The authors report a case of an asymptomatic 30-year-old female patient with an extensive cystic lesion continuous with the splenic parenchyma. A review of the literature and use of a videolaparoscopic approach to the treatment of these lesions is presented.

Videolaparocholecystectomy: casuistry of 1000 cases.

Despite the ongoing evolution in the medical treatment of biliary pathology, the standard of treatment for gallstones remains cholecystectomy. There are no alternative treatments that have shown the same efficacy as surgery. Current alternative treatments have shown high recurrence and failure rates. Cholecystectomy remains the gold standard for management of gallstones. The surgical access of laparoscopic cholecystectomy accomplished by Mouret in 1987 allows for a reduction in operative trauma, hospital stay, postoperative pain and convalescence. These factors permit a faster return to normal activities. Today, laparoscopic cholecystectomy is performed in almost all medical centers around the world; however, the procedure is not free of complications. The objective of this study was to analyze our first 1000 cases of laparoscopic cholecystectomy, giving emphasis to the morbidity and mortality of the procedure.

Non-traumatic acute abdomen: videolaparoscopic approach.

BACKGROUND AND OBJECTIVE: Although videolaparoscopy has been considered a safe method for many elective procedures, its use in traumatic and non-traumatic acute abdomen needs to be evaluated. The aim of this article is to evaluate the role of videolaparoscopy in non-traumatic acute abdomen as a method of diagnosis and treatment. METHODS: Between January 1992 and December 1996, 462 patients' charts were reviewed, retrospectively. Patients were admitted to the emergency room of São Rafael Hospital with symptoms of non-traumatic acute abdomen. Routine investigation of abdominal pain was performed in all patients, followed by videolaparoscopy. The laparoscopic procedures were done with four main purposes: diagnosis (ie, enteritis); diagnosis and treatment (ie, appendicitis); treatment only, when the diagnosis was known (ie, acute cholecystitis); and in cases where the conversion to conventional laparotomy was necessary, indicating the best incision. RESULTS: The vast majority of patients had inflammatory causes of acute abdomen (82.03%); others causes were hemoperitoneum (11.03%), bowel obstruction (3.25%), perforation of a hollow viscera (1.74%), vascular occlusion (1.3%), and negative laparoscopy (0.65%). CONCLUSIONS: This study shows that laparotomy was necessary in only 7.14% of the patients. The videolaparoscopic approach was used for diagnosis (99.35%) and treatment (92.86%) of patients with acute abdomen.

Tooth whitening with hydrogen/carbamide peroxides in association with a CPP-ACP paste at different proportions.

BACKGROUND: Different enhanced peroxide formulations have been developed to overcome mineral loss during tooth whitening. This study investigated the impact on tooth whitening from combining a CPP-ACP paste with home peroxide agents at several proportions. METHODS: Ninety bovine incisors were randomly allocated into nine groups (n = 10) and exposed to 7.5% hydrogen peroxide (HP), 16% carbamide peroxide (CP), a CPP-ACP paste (Tooth Mousse/MI Paste, GC Corporation, Tokyo, Japan) and blends of HP/CP:MI at three proportions (1:1, 2:1 and 1:2). Tooth whitening was performed for 14 days and its effectiveness was measured by a spectrophotometer utilizing the CIE L*a*b* system (ΔE, ΔL*, Δa* and Δb*). Colour readings were measured at baseline (T0), 7 days of bleaching (T7), 14 days of bleaching (T14) and 7 days after the end of bleaching (T21). Data were analysed by two-way ANOVA for paired averages followed by the Tukey's test and Pearson's correlation at 5%. RESULTS: Although CP produced the greatest colour change (ΔE), all whitening protocols were considered to be effective regardless of the CPP-ACP presence. In general, greater changes in ΔE, ΔL*, Δa* and Δb* were detected at T14, with T21 exhibiting similar results to those at T7. A greater number of strong correlations with ΔE values was found for a* (11/15). CONCLUSIONS: Within the limitations of this study, the results indicate that the CPP-ACP paste did not affect tooth whitening efficacy.

Acute cholecystitis secondary to hemobilia after percutaneous liver biopsy.

A case of obstructive acute cholecystitis following percutaneous liver biopsy is presented. The patient complained of intense and continuous pain in the right upper quadrant of the abdomen 2 days after the liver biopsy. On abdominal examination, Murphy's sign was present. Hemogram revealed a fall in the hematocrit level from 44 to 38 because of hemobilia. Ultrasonography showed a dilated gallbladder with moderate thickness of the wall and a blood clot of 20 x 9 mm inside. The patient was subjected to laparoscopic cholecystectomy. The acute inflammation of the gallbladder was secondary to obstruction of the cystic duct by the blood clot. The postoperative period was uneventful.

Monozygotic twins with Turner's syndrome and mos 45,X/46,X,r,(Y).

A pair of monozygotic twins with Turner's syndrome was studied using combined cytogenetic techniques and a mos 45,X/46,X,r(Y) was demonstrated in both. One of the twins presented clitoral hypertrophy. Surgery was performed and uterus, bilateral Fallopian tubes, bilateral epididymis and bilateral streak gonads with a small nodule of testicular tissue containing numerous seminiferous tubules were found in both.

G-11 staining in Turner's syndrome with mos 45,X/46,X,r(?).

Mos 45,X/46,X,r(?) in 4 patients with Turner's syndrome and no signs of virilization, and in one pair of monozygotic twins, one of them with clitoral hypertrophy, was studied using combined cytogenetic techniques and specially G-11 staining for the characterization of the X or Y origin of the rings. In all 6 patients the ring was G-11 positive, attesting its Y origin. Both twins were operated and bilateral streak gonads with a bilateral nodule of testicular tissue were found. Similar small rings were also studied in one patient with mos 46,XX/46,X,r(X) and in one nonvirilized Turner's syndrome patient with a larger ring; in these two cases the ring was G-11 negative. It seems that the small rings occasionally found in Turner's syndrome are more frequently from Y origin and therefore prophylactic gonadectomy should be considered.

Combined cytogenetic techniques and non-fluorescent Y. Cytologic evidences of dic(Yp)(q11) in a previously interpreted 46,X,Yq-.

mos 45,X/46,X,Y with no bright fluorescence was studied in 4 patients presenting variable phenotypes, from Turner's syndrome, with or without virilization, to ambiguous external genitalia, with combined cytogenetic techniques. G-11 staining demonstrated, in all cases, that the abnormal Y was a dic(Yp). Considerations about the possibility that some of the 46,X,Yq-males attending infertility clinics may be examples of dic(Yp) are made.